Impact of ischemic time on post-infarction left ventricular function in ST-elevation myocardial infarction treated with primary percutaneous coronary intervention

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• 作者：Sunanto Ng ; Jan Paul Ottervanger ; ^{v.r.c.derks@isala.nl} ; Arnoud W.J. van 't Hof ; Menko-Jan de Boer ; Stoffer Reiffers ; Jan-Henk E. Dambrink ; Jan C.A. Hoorntje ; A.T. Marcel Gosselink ; Harry Suryapranata
• 关键词：Ischemic time ; Post-infarction ; Left ventricle function
• 刊名：International Journal of Cardiology
• 出版年：2013
• 出版时间：25 May, 2013
• 年：2013
• 卷：165
• 期：3
• 页码：523-527
• 全文大小：328 K

文摘

Background

Myocardial necrosis is a time-dependent event. Nevertheless, clinical studies on association between ischemic time and left ventricle function showed inconsistent findings. Aim of current study is to evaluate the association between ischemic time and the post-infarction left ventricular function in ST-elevation myocardial infarction treated with primary PCI.

Methods

In 2529 patients treated with primary PCI, left ventricular ejection fraction (LVEF) was measured before discharge (median day 4) by radionuclide ventriculography or by echocardiography if patients had atrial fibrillation. Ischemic time was calculated from symptom onset to first balloon inflation.

Results

The correlation between ischemic time as continuous variable and LVEF was significant but weak (P = 0.002, r = ? 0.062). The LVEF of patients in ischemic time intervals of > 6, > 3-6, and ¡Ü 3 h was 45.1 ¡À 11.7 % , 44.6 ¡À 11.9 % , and 43.2 ¡À 12.2 % , respectively (P = 0.029). Adjusted odds ratio of the ischemic time intervals for LVEF < 40 % was 1.14 (95 % CI 1.00-1.30). TIMI flow 0 before and TIMI flow 3 after PCI were related with both longer ischemic time and low LVEF.

Conclusion

Ischemic time was associated with post infarction LVEF in patients treated with primary PCI, although this association was weak. Initial TIMI flow and post-PCI TIMI flow played important role in impact of the ischemic time on the LVEF.